Alternative medicine: How to figure out what works (and what doesn’t)

When I tell people about the Evidence-Based Living Blog, many of them want to know about alternative medical treatments. “Does X really work?” they will ask. “X” could be anything from ginkgo biloba, to meditation, to massage, to dietary supplements. Answering that question has always been hard for me, because finding and evaluating the evidence seems so complex.

The clearest explanation I have ever seen comes from Dr. Mark Lachs in his terrific new book Treat Me, not My Age. It’s a book targeted to the baby boomers and beyond about how to get the best care as one gets older. But it’s filled with general advice for how to work with your physician to get optimal care, no matter how old you are.

Dr. Lachs begins by noting that his patients are often surprised when he tells them that he’s open to alternative therapies. In fact, he’s prescribed meditation and yoga, recommends massage, and suggests certain supplements be tried first instead of medications. His advice to his patients is critically important however: You don’t need to be defensive about alternative treatments – but you have to understand what you are taking and whether it actually works.

The first thing Dr. Lachs recommends is that you do your own research. In case you feel that’s too daunting, he reminds us that we often find researching consumer purchases, like a new car, enjoyable – so why not research alternative treatments? He suggests (as we so often also do here at EBL) that you access the scientific evidence yourself.

Dr. Lachs gives you two approaches: the easier “take-out” approach, and the “do-it-yourself” approach. If you don’t want to look up scientific articles yourself, one key source is the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health. It has lots of easily accessible information on supplements and alternative therapies. The Cochrane Collaboration is another site where you can find scientific reviews of alternative therapies.

You can also access the scientifc research yourself. But how do you evaluate the evidence you find in these articles? Here’s where Dr. Lachs really helps us. He sums up five things you need to consider (the headings are Dr. Lachs’s):

Make sure that what’s being studied is what you’re interested in. Sounds simple, but actually it’s how many people take a wrong turn. For example, say you want to take a supplement – you have to make sure that the research is about the same dosage and ingredients, or it may not apply to you. For something like yoga or massage, read the article carefully to see if there are other treatments involved in the study, how long people did the activity, and similar specifics.

Be sure the patients in the study are as like you as possible. Were the people in the study like you? Something that benefits 60-year olds may not apply to college students, and vice versa. Look for studies with people close to you in age, same gender, and other characteristics.

Assess the quality of the study. You can look on this site under The Learning Center for posts about evaluating study quality. Dr. Lachs notes that you should look for randomized trials, where people are randomly assigned into a group that gets the treatment or that doesn’t. Also look for how well people stuck with the therapy over time and side effects reported.

Look for self-effacing scientists. Good scientists talk a lot about the limitations of their studies at the end of the article. Be skeptical if the authors are too unequivocally positive about a treatment.

Involve your physician in this “journal club.” Talk to you doctor about what your research has found; you can even share a scientific article with him or her. Dr. Lachs says this may make your physician more amenable to trying an alternative treatment.

Here’s what I love about Dr. Lachs’s perspective: It empowers all of us patients. He encourages us to drop rigid views: either “all alternative treatments are better than regular medicine” or “all alternative treatments are garbage.” We have the power to find out the scientific evidence and share it with our physicians – and that’s a very healthy thing in and of itself!

Seems like a really great book. Surprised to see that it’s rated as 5 stars by 90% of the reviewers. I’ve also heard few positive feedbacks from my colleagues too. Will definitely buy it soon! Thanks for the great review

Physicians have failed to convince the public that alternative medicine is (usually) a waste of money. Perhaps the reason for this is precisely as this essay has put it: instead of telling the patients “what to think” we should tell them “to think for themselves.” This way, a patient can understand “why” alternative medicine is (usually) garbage instead of taking it on faith. I think this is a great idea! Though, I must add, that the physician makes sure s/he discusses the patient’s research with the patient. That way, the patient can be given feedback as to how the critical thinking process of research works. Cool!

Or maybe “physicians have failed to convince the public that alternative medicine is (usually) a waste of money,” because it isn’t. How quickly you refer to other methods as “garbage” makes me think you haven’t done much research into CAMs, despite more and more modern doctors beginning to embrace it due to its tangible, often quantifiable benefits. Don’t forget, it was only about a hundred years ago since allopathic medicine’s take-over of patient care (not because it was better, but for complex economic gain reasons). Many people believe the general decline of American health is related to the prevalence of allopathic medicine’s “symptom management” style, rather than a style that finds and treats the root cause of disease. If you are or are studying to be a doctor, I would not be so quick to dismiss CAMs, especially as they begin to gain more popularity in the mainstream.

I am so happy I found an article that explains alternative medicine in a way that’s accessible to those of us who don’t understand all the terminology. I really liked the part about doing your own research as that’s the best way to find information that is relevant and useful to you. Excellent advice

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The blog is based on one key principle: Now more than ever, people need help separating the good scientific information from the bad. We are all about assessing the scientific evidence on human problems and looking at how to use it every day. You can click on the topics above to see blog posts on specific subjects.